Field of the Invention
[0001] The present invention relates to a transparent dilator device for use in a lumen
of a patient's body.
Background
[0002] Constriction of natural body lumens, such as those of the human gastrointestinal
tract, can occur in numerous ways. Some strictures are caused by muscular spasm, others
by disease, and others by injury. Regardless of the cause, the typical method of treatment
is to physically dilate the region using a medical device designed for that purpose.
[0003] Several types of devices are used for dilation. One generally established type is
a bougie. Bougie tubes may be in the form of a mercury- or tungsten-filled tube with
a tapered end that gradually opens the strictured esophagus as it is pushed past the
treatment site. These devices come in a series of increasing sizes, each tube having
a single effective dilating diameter, generally between 10 and 60 French. (French
is a measure of circumference based on the diameter in millimeters, mm.) The bougie
is typically introduced blindly after the physician has judged the proper beginning
size with an endoscope. Some physicians follow a rule of thumb not to dilate a stricture
more than three successive French sizes (3 mm) in a single session. If the lumen has
not satisfactorily been opened after three sizes, the patient returns at a later time
for another treatment session.
[0004] Another type of device is a wire-guided dilator. These devices are passed into the
patient over a guidewire that has been pre-fed along a lumen of the gastrointestinal
tract. The guidewire keeps the tip of the device in the lumen while it is being passed,
to avoid perforating through the wall of the lumen. These devices have a single outer
dilating diameter and typically have a radiopaque component so that they are visible
under fluoroscopy. The following patent documents disclose various devices in the
art: US 5,366,471; US 6,334,863; US 5,766,202; and GB 2023009A.
[0005] A third type of dilating device is a balloon. Balloon dilators may be comprised of
polyethylene, and may be introduced through the working channel of an endoscope. The
physician views the proximal end of a stricture site with an endoscope and introduces
the deflated balloon into the narrowed area. The balloon is then inflated with saline
or other fluid to effectively open the stricture site pneumatically. Balloons provide
the advantages of multiple dilator diameters with a single intubation, passage through
the working channel of an endoscope, and visualization of a stricture site from the
proximal end.
[0006] Other devices such as double tapered bougies, pneumatic bougies, illuminating bougies,
solid dilator devices attached to the distal end of an endoscope, and variable stiffness
dilators have been previously described in the art. The following patent documents
disclose various types of devices in the art: US 6,010,520; US 4,832,691; US 5,624,432;
US 5,718,666; WO 98/47422.
Summary of the Invention
[0007] Applicants have recognized the need for a relatively low cost dilator (disposable
or non-disposable) which is relatively easy and convenient to use, and which allows
the physician to directly visualize the stricture being dilated. In one embodiment,
the present invention provides a medical device for use in dilating a body lumen.
The medical device comprises at least one generally transparent segment, and a channel
associated with the transparent segment for receiving a visualization device. The
transparent segment includes at least one outer surface having a diameter sized for
providing dilation. In one embodiment, the device can comprise a plurality of transparent
sections, each section having an outer surface portion with a different diameter sized
for sequential dilation of a stricture. The medical device can include at least one
marking associated with the transparent segment for indicating the position and/or
value of a dilation diameter.
[0008] The present invention also provides a method for dilating a portion of a body lumen.
In one embodiment, the method can comprise the steps of: providing a medical device
having at least one outer surface portion sized for providing dilation of a body lumen;
inserting said outer surface portion into said lumen; advancing said outer surface
portion in said lumen to dilate said lumen; and viewing dilation of said lumen through
said outer surface portion of said medical device, such as by viewing the body lumen
with a visualization device positioned within a channel in the medical device. The
step of viewing dilation can comprise viewing the lumen through a transparent segment
of device, wherein the transparent segment includes multiple outer diameters sized
and arranged for sequential dilation.
Brief Description of the Drawings
[0009] While the novel features of the invention are set forth with particularity in the
appended claims, the invention in all its embodiments may be more fully understood
with reference to the following description and accompanying drawings.
FIG. 1 is a side view of wire-guided dilator 10, described in prior art, including
a guidewire channel 13, a first radiopaque marker 14, and a second radiopaque marker
15.
FIG. 2 is a side view of a first embodiment of the present invention, a dilator 18
which includes a handle 19, a tube 20, a transparent segment 21, and a tapered tip
22.
FIG. 3 is a sectional view of dilator 18 from FIG. 2 with an endoscope 50 inside a
body lumen 60, proximal to a stricture 61.
FIG. 4 is a detailed view of transparent segment 21 and tapered tip 22 shown in FIG.
2, including a first outer diameter D1, a conical inner contour 32 inside tapered
tip 22, an exterior taper angle theta1, and a narrow leading edge 34.
FIG. 5 shows a detail view of a preferred embodiment of transparent segment 21, including
a second outer diameter D2, a third outer diameter D3, a plurality of markings 43,
and at least one transition 44.
FIG 6 shows endoscope 50 inside a cross section view of dilator 18 shown in FIG 5,
taken at line 6-6, including a field of view 52.
FIGs. 7A-7D illustrate steps which can be performed in using dilator 18 with an endoscope
50. FIG. 7A) is a sectional view of dilator 18 from FIG. 5 and field of view 52 of
endoscope 50 positioned for advancement into body lumen 60 to a stricture 61. FIG.
7 B) is a sectional view of dilator 18 from FIG. 5 and field of view 52 of endoscope
50 positioned at first viewpoint 53 dilating to first outer diameter D1. FIG. 7 C)
is a sectional view of dilator 18 from FIG. 5 and field of view 52 of endoscope 50
positioned at second viewpoint 54 dilating to second outer diameter D2. FIG. 7 D)
is a sectional view of dilator 18 from FIG. 5 and field of view 52 of endoscope 50
positioned at third viewpoint 55 dilating to third outer diameter D3.
Detailed Description of the Invention
[0010] The present invention relates to the field of medicine, specifically to surgery,
urology, or gastroenterology, in which a physician intends to alter the size of a
constricted body lumen in a patient, or otherwise temporarily or permanently enlarge
a portion of a body lumen. By way of example, the present invention is illustrated
and described for application to an esophageal stricture of a human patient. However,
the present invention is applicable for use in other natural lumens of human patients,
including the urinary tract, biliary tract, lower gastrointestinal tract, or bronchus;
and the present invention may also be used in other animals (e.g. for veterinary medicine),
including mammals other than humans.
[0011] FIG. 1 shows a wire-guided dilator 10 described in prior art, including a guidewire
channel 13, a first radiopaque marker 14, and a second radiopaque marker 15. Guidewire
channel 13 allows wire-guided dilator 10 to be passed over a previously placed guidewire
along the lumen of a patient. First radiopaque marker 14 and second radiopaque marker
15 are detectable under fluoroscopy to determine the position of wire-guided dilator
10 relative to a strictured area. This provides confirmation to the physician of dilation
to the full diameter of the device. The fluoroscopy procedure can be costly and can
expose the physician and patient to radiation.
[0012] FIG. 2 shows a dilator 18 of the present invention, including a handle 19 at the
device's proximal end, a tube 20, a transparent segment 21, and a tapered tip 22 at
its distal end. Handle 19 of FIG. 2 includes a longitudinal channel for receiving
an endoscope 50 (see FIG 3). Handle 19 provides the physician a location to grip dilator
18 and may be made from an elastic material, such as silicone. In one embodiment,
the proximal portion of handle 19 can have an opening (such as an opening in a flexible,
elastic seal or boot made of silicone or a suitable flexible elastic polymeric material),
the hole being slightly smaller than the diameter of the endoscope. Such an arrangement
can provide frictional engagement of the handle 19 with the endoscope 50 due to the
drag force encountered in passing the endoscope through the opening. This feature
allows the physician to hold either endoscope 50 or tube 20 in a one-handed fashion
to position both the endoscope and the dilator 18 with direct visualization of a body
lumen 60 (FIG. 3) during introduction or advancement of the device.
[0013] Tube 20 shown in FIG. 2 may be made of a flexible polymer, examples of which include
polyvinyl chloride (PVC), thermoplastic elastomer (TPE), polyurethane, or silicone.
In one embodiment, tube 20 is made of a transparent flexible polymer, but it may also
be made from an opaque material. A suitable transparent material from which tube 20
can be manufactured is available as 2222RX-70 Clear 000X from Alpha-Gary Corporation
(Leominster, MA). Commercially available clear flexible PVC tubing such as Kuri Tec
K050 0810 from Kuriyama of America Inc. (Elk Grove Village, IL) may also be used for
tube 20.
[0014] First channel 23 of FIG. 2 is appropriately sized to receive endoscope 50 (see FIG.
3). Various endoscopes of varying types and sizes may be used inside the present invention,
including, but not limited to, bronchoscopes, colonoscopes, cystoscopes, and gastroscopes.
Endoscope 50 may comprise a fiberscope or a videoscope, and may employ a CMOS (Complimentary
Metallic Oxide Semiconductor) chip, a miniature camera, or other visualization device.
In one embodiment, first channel 23 may be about 2mm greater in diameter than the
diameter of endoscope 50 used in the procedure so that relative motion between endoscope
50 and dilator 18 can occur smoothly under physician control. By way of example, a
9.5mm diameter gastroscope could be inserted into an 11.5mm diameter first channel
23 of dilator 18 to dilate an esophageal stricture. However, dilator 18 can be sized
and configured to accommodate other endoscopes. In various other embodiments, first
channel 23 may have a diameter in the range of, but not limited to, about 3mm to about
15mm.
[0015] Fourth outer diameter D4 of FIG 2 can be made as small as feasible for reason of
patient tolerance during the procedure. Fourth outer diameter D4 may be the same as
the largest diameter of transparent segment 21, or alternatively, D4 may be less than
the largest diameter in transparent segment 21. The dimensions of first channel 23
and fourth outer diameter D4 determine the wall thickness of tube 20. This wall thickness
should provide adequate axial stiffness to advance transparent segment 21 of dilator
18 past stricture 61 without kinking, when used in conjunction with endoscope 50.
The presence of endoscope 50 inside tube 20 during advancement adds to the stiffness
of dilator 18, and greatly reduces the likelihood of kinking or folding tube 20 during
use. When tube 20 is made from a flexible polymer such as a flexible PVC material,
wall thickness including a range from about 1mm to about 4mm may be used. If a portion
of transparent segment 21 is made from a relatively more rigid material, a wall thickness
of 1mm or less may be used.
[0016] The length of tube 20 in FIG. 2 should be appropriately sized to comfortably reach
the targeted area within the body while handle 19 remains outside the body for physician
control. A low coefficient of friction on tube 20 allows easy sliding along the surface
of body lumen 60. And, because the physician can reposition endoscope 50 within tube
20 to get a different view, easy sliding of endoscope 50 within tube 20 may also be
desired. A suitable lubricant or low friction material (wet or dry) can be employed.
For instance, a lubricating gel may be used to lower the coefficient of friction between
tube 20 and body lumen 60, and between endoscope 50 and tube 20. Likewise, a suitable
lubricant or other low friction material (such as a coating 31 shown in Figure 4)
could be applied to the inner or outer surfaces (or both) of tube 20 or transparent
segment 21 (or both) to facilitate sliding of endoscope 50 within tube 20 and also
sliding of tube 20 within body lumen 60.
[0017] FIG.3 shows the dilator 18 being used in body lumen 60 to dilate a stricture 61.
Dilator 18 dilates stricture 61 in body lumen 60 under direct visualization by endoscope
50 positioned inside the device, allowing the physician to see along the entire length
of stricture 61 from the inside out. The invention replaces the current methods of
dilating body lumen 60 without direct visualization and improves on current methods
of dilating with balloons and other devices that allow visualization from only the
proximal side of stricture 61 during the procedure. By way of example, this illustration
shows the invention used to dilate an esophageal stricture, but it could be used to
dilate constrictions in other body lumens.
[0018] Transparent segment 21 shown in FIG. 4 and in FIG. 5 is a transparent portion of
the device through which a physician views the stricture 61 during dilation of stricture
61. Transparent segment 21 extends from the distal portion of tube 20 and may be made
of a transparent material, including clear PVC, TPE, polyurethane, glass, or polycarbonate.
Attachment means for attaching transparent segment 21 to tube 20 may include a flange
with adhesive, a plurality of mechanical ribs, a plurality of screw-type threads,
or other combinations of geometric projections and adhesives. Tube 20 and transparent
segment 21 may also be formed as a single, unitary piece, such as by forming tube
20 and transparent segment 21 together by molding or casting. Rigid segments may also
be incorporated into transparent segment 21, especially in instances where wall thickness
is about 1mm or less. Such rigid segments could be over-molded in place or fixed by
adhesive in a desired location. In one embodiment, first channel 23 (FIG. 2) extends
into transparent segment 21 so that endoscope 50 may be advanced within transparent
segment 21.
[0019] The transparency of transparent segment 21 allows direct visualization of tissue
outside the device from endoscope 50 located within the device. Therefore, it can
be desirable to minimize distortion or obstruction of view through transparent segment
21. Suitable transparency of transparent segment 21 can be accomplished by controlling
material selection and molding finish. The material from which transparent segment
21 is constructed should be clear, and the mold used should be polished so that the
molded part has a smooth outer surface. Transparent segment 21 may include markings
43 (Figure 5) such as one or more markings 43 indicating the outside diameter of transparent
segment 21 at the longitudinal position of the particular marking. Anatomical landmarks,
color variations, tissue differences, foreign bodies, and any markings 43 (FIG. 5),
and other items of interest should be recognizable when viewed with endoscope 50 disposed
within transparent segment 21. An appropriate material for transparent segment 21
can have a haze value of about 5% or less, and have a light transmission property
of about 80% or greater. Haze value is a material property, expressed in percent,
describing the amount of "cloudiness" in a material caused by particulate impurities,
molecular structure, or degree of crystallinity, resulting in scattering of light
and apparent cloudiness. Light transmission is a material property indicating the
percentage of incident light that passes through an object. In addition to using transparent
material to form segment 21, a mold used to create segment 21 can be highly polished
to create a smooth surface that does not distort the view seen through endoscope 50
when the viewing device of endoscope is disposed inside segment 21 to view lumen tissue
outside of segment 21.
[0020] Having a low coefficient of friction of transparent segment 21 allows the device
to slide freely inside body lumen 60, especially during dilation of stricture 61.
Lubricating gel, such as K-Y brand lubricating jelly available from Johnson and Johnson
can be used to lower the coefficient of friction during use. In one embodiment, a
coating 31 (FIG. 2) can be disposed on one or both of the inner and outer surfaces
of the transparent segment 21, in which coating 31 is transparent and has a lower
coefficient of friction when hydrated than when dry. One example of coating 31 is
a hydrogel material made by the interaction of polyvinylpyrrolidone with one or more
isocyanate prepolymers. A coating such as Hydromer® Lubricious Medical Coatings by
Hydromer Inc. (Somerville, NJ) can be used for coating 31. Such a coating can reduce
the drag force along the axis of a lumen during dilation, creating a more efficient
device when compared to existing dilators.
[0021] FIG. 4 shows a section view of dilator 18 including a first outer diameter D1 and
a tapered tip 22. Tapered tip 22 may be made of a flexible polymer that is pliable
compared to body tissue and may be attached to the distal end of transparent segment
21. In one embodiment, tapered tip 22 can be made with the same material as transparent
segment 21, if transparent segment 21 is made of a flexible polymer. In one embodiment,
a biomedical grade of clear flexible PVC having a hardness value of about 60 to 80
on the Shore A scale can be used to form tapered tip 22 and transparent segment 21.
For example, a clear flexible PVC material such as XV-3450 from PolyOne Corp. (Avon
Lake, OH) could be used to mold both transparent segment 21 and tapered tip 22 as
a single part. Another material from which tip 22 and segment 21 may be formed is
material designated 2222RX-70 Clear 000X from Alpha-Gary Corp (Leominster, MA), which
material can be gamma stable to allow gamma radiation to be used for sterilization.
Other suitable materials such as TPE or polyurethane can also be used.
[0022] Tapered tip 22 facilitates intubation into body lumen 60 by gradually tapering from
a first outer diameter D1 to a narrow leading segment 34 with an exterior taper angle
theta1, as shown in FIG. 4. In one embodiment, tapered tip 22 includes a second channel
27 in communication with a conical inner contour 32 and first channel 23 so that the
device can be threaded over a guidewire. Second channel 27 can be sized appropriately
for a guidewire, including diameters in the range from about 0.5mm to about 1.5mm.
Exterior taper angle thetal can be selected to provide a desired amount of radial
force transmitted against stricture 61 for a given level of axial force (force parallel
to length of the dilator 18) applied by the physician. Generally, a low value of exterior
taper angle provides an efficient, comfortable transmission of radial force against
the stricture, with the trade-off that low values of exterior taper angle generally
increase the length of the dilator 18 that must be inserted past the stricture. For
instance and without limitation, the dilator can have an exterior taper angle theta
in a range including about 3 degrees to about 15 degrees. In one embodiment, the taper
angle can be between about 6.5 and about 7.5 degrees.
[0023] FIG. 4 shows conical inner contour 32 connecting first channel 23 to second channel
27 with an interior taper angle theta2. The connection has a conical shape to reduce
the glare from endoscope 50 during use. Conical inner contour 32 also facilitates
molding by allowing a central core pin to be tapered for ease of removal. In one embodiment,
the value of interior taper angle theta2 is different from value of exterior taper
angle theta1 to provide a varying wall thickness along the length of the device, so
that radial strength can be tailored as needed along the length of the device. By
way of example, the exterior taper angle theta1 can be about 7 degrees, and the interior
taper angle theta2 can be about 6 degrees.
[0024] In FIG. 4, conical inner contour is shown initiating at the distal end of a segment
with first outer diameter D1, but other initiation locations are possible. For example,
if conical inner contour 32 initiates at a more proximal location (e.g. forward of
the "14 mm" marking in Figure 4), a thicker wall is created at the distal portion
of a segment with first outer diameter D1, providing radial stiffness to that area
while still allowing endoscope 50 to slide far enough to view out tapered tip 22 during
insertion. Such an arrangement can help ensure adequate radial strength of in the
portion of the device having inner diameter D1.
[0025] FIG. 5 depicts a preferred embodiment of transparent segment 21 comprised of a first
transparent section 21A having a first outer diameter D1; a second transparent section
21B having a second outer diameter D2, and a third transparent section 21C having
a third outer diameter D3, each pair of adjacent sections separated by a transition
44. The first, second and third sections can each be generally cylindrical. Transitions
44 provide a tapered (linear or curvilinear ) transition in diameter from the outer
diameter of one section to the outer diameter of the adjacent section. The transitions
can have can have a hollow conical configuration, such as a conical shape generally
the same as that of a truncated cone having a centrally located passageway. Alternatively,
the dilator 18 can have diameters D1, D2, D3, and D4 on a single continuous outer
surface portion which is tapered linearly or curvilinearly from D1 to D4.
[0026] Figure 5 also shows plurality of markings 43 for the physician to select and position
the desired dilating diameter in the area of stricture 61 during the procedure. Markings
43 provided to be visible through the optical device (e.g. camera, fiber optic cable,
etc.) associated with the endoscope 50 and may have several uses, including delineating
the boundaries of a single dilating diameter, or indicating the numeric value of a
dilating diameter. Markings 43 may be molded into the part, applied with ink, etched
on the device, or applied by any other suitable method. In one embodiment, numerical
indications may be applied to the outer surface of transparent segment 21 in multiple
locations, some of which are readable by endoscope 50 from inside the device (necessitating
them to appear backwards from the exterior of the device, but appearing forward from
inside the device), and some of which are readable from the exterior of the device
(appear backward from endoscope 50 inside the device). In addition to markings comprising
numerals or letters, other embodiments of plurality of markings 43 may include use
of various other indicia, including without limitation one or more different colors,
and/or use of different geometric shapes, such as to designate different sections
or segments, or attributes of different portions of the device. For instance, a row
or column of circles could be used to designate a first section, a pattern of circles
and dashes could designate a second section, and a pattern of circles, dashes, and
squares could designate a third section. Markings 43 can also be coated or otherwise
treated with a substance to make them luminous or glow in reduced lighting.
[0027] FIG. 6 shows a cross section of transparent segment 21 and tapered tip 22 of FIG
5 taken at line 6-6 with endoscope 50 positioned inside. A field of view 52 is depicted
to indicate the area in view by the physician. Because endoscope 50 is movable with
respect to dilator 18, a change in the position of endoscope 50 allows the physician
to see a different area of body lumen 60 within field of view 52.
[0028] FIGs 7A-7D show four possible steps a physician may use to dilate stricture 61 with
dilator 18 and endoscope 50. FIG. 7A shows the relative positions of endoscope 50
and dilator 18 upon insertion into body lumen 60 to a location of stricture 61. In
this position, field of view 52 is used to view body lumen 60 during insertion, and
to view the proximal location of stricture 61.
[0029] FIG 7B shows endoscope 50 at a first viewpoint 53 so field of view 52 includes first
outer diameter D1. While viewing plurality of markings 43 for reference, dilator 18
is advanced into stricture 61 causing dilation to first outer diameter D1. Plurality
of markings 43 may delineate the boundaries of diameter D1 and may also indicate its
numerical value. In this manner, the physician has a visual indication through endoscope
50 of where to position dilator 18 with respect to stricture 61 for precise dilation
to a desired diameter.
[0030] FIG. 7C shows a next potential step to further dilate stricture 61 if desired by
the physician. Endoscope 50 is placed at a second viewpoint 54 relative to dilator
18 so that field of view 52 includes second outer diameter D2. The medical device
is further advanced into stricture 61 to further dilate to second outer diameter D2
while viewing another portion of plurality of markings 43 for reference.
[0031] FIG. 7D shows endoscope 50 at a third viewpoint 55 so that field of view 52 includes
third outer diameter D3. Again, the medical device may be further advanced to dilate
stricture 61 to third outer diameter D3 while again viewing yet another portion of
plurality of markings 43 as a reference. In this manner, the physician can visually
examine the entire length of a stricture with endoscope 50 as the dilation occurs.
[0032] An alternative method of use is to first place a guidewire in body lumen 60 of the
patient, then thread dilator 18 over that guidewire using second channel 27, conical
inner contour 32, and first channel 23. Dilator 18 may then slide into the guidewire,
after which endoscope 50 may be placed into first channel 23. The guidewire does not
need to be threaded through the working channel of endoscope 50, but a physician may
do so if desired. The combination of endoscope 50, dilator 18, and guidewire could
then be used according to the steps illustrated in FIGs. 7A-7D.
[0033] A physician advancing a dilator through a stricture 61 will normally feel resistance.
In prior art devices where the physician attempts to "blindly" introduce a dilator,
perforation or other damage to the body lumen may occur. Further, if such damage occurs,
the physician may not immediately recognize that damage has occurred. The present
invention can permit the physician to visualize a medical procedure (e.g. dilation
of a stricture) as the procedure is performed, thereby providing the physician with
immediate feedback on the state of the tissue being treated. Such visualization can
help in avoiding unintended damage of tissue which might otherwise occur if the physician
is not able to directly visualize the procedure. In the unlikely even that damage
does occur, the physician can immediately notice it and can choose to cease treatment
and begin a new course of action to repair the damage. Direct visualization provided
by endoscope 50 inside dilator 18 allows the physician to know that he/she has not
perforated, bruised, or otherwise damaged body lumen 60.
[0034] Another useful feature of the dilator 18 is that it provides one with the ability
to dilate to more than one diameter with a single introduction of the device, and
with precision. This is made possible by the ability to see plurality of markings
43 from inside transparent segment 21 to identify a particular dilating diameter.
Previously disclosed devices with multiple diameters rely on tactile feedback, remote
markings, or costly pressure meters ( e.g. in the case of balloons) to control the
diameter. The intuitive nature of plurality of markings 43 allows the physician to
easily select the desired diameter by looking clearly through the device, along the
whole length of stricture 61, adding precision to the device when compared to current
methods, which may involve elaborate measuring schemes.
[0035] Dilator 18 can also be less costly to manufacture than some balloon style dilators.
Accordingly, devices of the present invention may be cost effectively packaged and
sold as a single-use, disposable product which does not require cleaning or re-sterilization.
Dilator 18 can be pre-sterilized and packaged in a sterile pouch or other suitable
package.
[0036] Dilator 18 can also provide reliability in terms of dilating diameter compared to
certain balloon type dilators. Some balloons may not hold a constant diameter when
inflated, so the dilation is not as reproducible as a tube of known size being passed
through a constricted area. Dilator 18 provides two-vector shearing of stricture 61.
This results from sliding a tapered-tip device through a narrowed area, thereby applying
forces in both the axial and radial directions. Balloons typically only apply a generally
radial directed force to a stricture.
[0037] Dilator 18 can also provide affordable and convenient dilation with the ability to
directly visualize the treatment along the entire length (not just a proximal or distal
portion) of a stricture 61 without the use of expensive or potentially harmful radiographic
equipment to confirm placement. When using radiographic equipment, a dilation procedure
is typically performed in a radiographic suite, which often requires additional logistics
of scheduling an additional appointment and different staffing needs, which in turn
can require additional time and cost. Dilator 18 can provide complete direct visualization
with endoscope 50 without the additional costs or time associated with radiographic
equipment.
[0038] The present invention has been illustrated as having a transparent segment having
generally circular cross-sections, but non-circular cross-sections (e.g. oval, elliptical,
polygonal) can also be used, in which case the term "diameter" will be understood
to refer to the maximum dimension of the non-circular cross-section used for providing
dilation. The present invention may be provided in kit form with other medical devices,
and the kit elements can be pre-sterlized and packaged in a sealed container or envelope
to prevent contamination. The present invention may be provided as single use disposable
device or alternatively, may be constructed for multiple uses.
[0039] While various embodiments of the present invention have been disclosed, it will be
obvious to those skilled in the art that such embodiments are provided by way of example
only. Further, each element or component of the present invention may be alternatively
described as a means for performing the function or functions performed by the element
or component. Numerous variations, changes, and substitutions will now occur to those
skilled in the art without departing from the invention. Accordingly, it is intended
that the invention be limited only by the spirit and scope of the appended claims.
1. A medical device for use in dilating a body lumen, the medical device comprising at
least one generally transparent segment, and wherein said transparent segment includes
at least one outer surface having a diameter sized for providing dilation.
2. The medical device of Claim 1 wherein said transparent segment comprises a plurality
of outer surface portions, each outer surface portion having a different diameter,
and said diameters sized for providing sequential dilation of a stricture.
3. The medical device of Claim 2 wherein said transparent segment comprises at least
three outer surface portions, each outer surface portion having a different diameter.
4. The medical device of Claim 1 wherein said transparent segment comprises at least
one marking for indicating the position of a diameter sized for providing dilation.
5. The medical device of Claim 1 wherein said transparent segment comprises at least
one marking for indicating the size of a diameter for providing dilation.
6. The medical device Claim 1 further comprising a channel associated with said transparent
segment, said channel sized for receiving an endoscope.
7. A medical device for use with an endoscope in dilating a body lumen, the medical device
comprising a generally transparent segment comprising at least one outer surface portion
having a first outer diameter sized for providing dilation of a body lumen, and a
first channel extending at least partially into said transparent segment, wherein
the channel is sized for receiving an endoscope.
8. The medical device of claim 7 further comprising a plurality of markings on said transparent
segment, wherein said plurality of markings are viewable with an endoscope positioned
in said channel.
9. The medical device of claim 8 wherein said plurality of markings delineates the portion
of said transparent segment having said first outer diameter.
10. The medical device of claim 8 wherein said plurality of markings indicates the numeric
value of said first outer diameter.
11. The medical device of claim 7 further comprising a tapered tip and a second channel
in said tapered tip in communication with said first channel, said second channel
for receiving a guidewire.
12. The medical device of claim 7 further comprising a coating for reducing friction,
wherein said coating is generally transparent.
13. The medical device of claim 12 wherein said coating is located on the inner surface
of said transparent segment.
14. The medical device of claim 12 wherein said coating is located on the outer surface
of said transparent segment.
15. The medical device of claim 7 further comprising a handle positioned proximally of
said transparent segment, wherein said handle includes a longitudinal channel in communication
with said first channel for receiving the endoscope.
16. The medical device of claim 7, wherein said transparent segment further comprises:
- a second outer diameter proximal to said first outer diameter, wherein said second
outer diameter is larger than said first outer diameter; and
- a third outer diameter proximal to said second outer diameter, wherein said third
outer diameter is larger than said second outer diameter.
17. A medical device for use with an endoscope, comprising:
- a tube comprising a first channel for receiving the endoscope;
- a transparent segment extending distally of said tube, said transparent segment
for dilating a body lumen, said transparent segment having a first outer diameter,
a second outer diameter, and a third outer diameter, said diameters arranged to provide
sequential dilation;
- a plurality of markings visable with an endoscope disposed in said first channel,
wherein said plurality of markings delineate a portion of said transparent segment
having said first outer diameter, said second outer diameter, and said third outer
diameter; and
- a tapered tip extending distally of said transparent segment.